Spine Curvature Disorders: Lordosis, Kyphosis, Scoliosis, and More What are the types of spine curvature disorders? There are three main types of spine curvature disorders, including: Lordosis. Also called swayback, the spine of a person with lordosis curves significantly inward at the lower back. Kyphosis. Kyphosis is characterized by an abnormally rounded upper back (more than 50 degrees of curvature). Scoliosis. A person with scoliosis has a sideways curve to their spine. The curve is often S-shaped or C-shaped. What causes spine curvature disorders? There are a number of health problems that may cause the spine to curve more than normal or be misaligned. The following conditions can cause lordosis: Achondroplasia . A disorder in which bones do not grow normally, resulting in the short stature associated with dwarfism Spondylolisthesis. A condition in which a vertebrae, usually in the lower back, slips forward Osteoporosis , a condition in which vertebrae become fragile and can be easily broken ( compression fractures ) What Is Kyphosis? Definition, Symptoms, & Treatment Medical Author: Jason C. Eck, DO, MS Jason C.

Eck, DO, MS Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery. Medical Editor: William C. Shiel Jr., MD, FACP, FACR William C. Shiel Jr., MD, FACP, FACR Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology. There are three main types of kyphosis: postural, Scheuermann's, and congenital. Most cases of kyphosis do not require any treatment. Physical therapy and exercise are often effective in postural and Scheuermann's kyphosis.

Surgery is recommended for congenital kyphosis and more severe cases of Scheuermann's kyphosis. What is kyphosis? The spine has a series of normal curves when viewed from the side. These curves help to better absorb the loads applied to the spine from the weight of the body. The cervical spine (neck) and lumbar spine (lower back) are have a normal inward curvature that is medically referred to as lordosisor "lordotic" curvature by which the spine is bent backward. The thoracic spine (upper back) has a normal outward curvature that is medically referred to as kyphosis or the "kyphotic" curve by which the spine is bent forward. In this discussion, the term kyphosis will be used to discuss abnormal kyphosis. The spine is normally straight when looking from the front. An abnormal curve when viewed from the front is called scoliosis . Scoliosis can occur from bony abnormalities of the spine at birth, growth abnormalities especially with adolescence, degenerative spinal changes in adulthood, or abnormal twisting of the vertebrae because of muscle spasm after an injury. The normal curves of the spine allow the head to be balanced directly over the pelvis.

If one or more of these curves is either too great or too small, the head may not be properly balanced over the pelvis. This can lead to back pain , stiffness, and an altered gait or walking pattern. Medically Reviewed by a Doctor on 8/23/2016 Sports Injuries Sports Injuries Scheuermann's Disease Treatment of Sports Injuries in the Young Athlete Although not common, back and neck injuries can occur in young athletes who participate in sports. Though injuries that cause back pain are not the most common cause of injury in the young athlete, they can cause frustration. Most athletic injuries to the back are sprains of the ligaments or strains of the muscles. However, several more serious conditions can have symptoms similar to a routine sprain or strain. Many injuries occur after repetitive overuse of the structures of the spine. Therefore, proper treatment of a young athlete always includes a good physician evaluation with imaging studies when necessary. Muscle Strains and Ligament Sprains Muscle strains and Ligament sprains are the most common injuries that cause back pain in the young athlete. They can be caused by athletic overuse, improper body mechanics and technique, lack of proper conditioning, insufficient stretching, as well as trauma.

The athlete will complain of back pain with activity and will feel relief with rest. Initial treatment may require a period of rest and removing the athlete from sports participation. Treatments may include medication and special exercise. Ice can be used along with pain medications, which should be used sparingly. In addition, other measures to control pain and restore motion are commonly used. Initially, ice and medications such as nonsteroidal anti-inflammatories can be used. For persistent symptoms, particularly those associated with muscle spasm, heat may also be very helpful. As pain decreases, the injured athlete should be shown proper exercise to assist recovery. An exercise program can be very beneficial to improve flexibility and strength of the appropriate muscles for athletic performance as well as to help decrease risk for another similar injury. It is also important to maintain aerobic conditioning during treatment for back pain. Aerobic exercise needs to be tailored to the athlete and performed as pain allows. The repetitive overuse of the spine (particularly rotation) should be avoided, at least initially. Before being released to return to play, sport-specific exercises that mimic activities of athletic competition are often included in the exercise program.

It is also always important to evaluate and correct poor technique and mechanics that may have predisposed the athlete to the initial injury. Spondylolysis & Spondylolisthesis Defects of a vertebra's pars interarticularis (spondylolysis) and the slippage of one vertebra in relation to another vertebra (spondylolithesis) are common causes of back pain in the young athlete. These injuries are often seen in athletes who participate in sports that require twisting and hyperextension of the spine, such as in gymnastics. The athlete usually complains of pain that worsens when arching the back. The physician must be alert because these injuries often appear to be a sprain or strain. X-ray images are often normal and special imaging studies such as bone scan and CT scan may be required to confirm the diagnosis. Recovery requires a period of relative rest, ice, medication and specific exercises. It is important that inflexible muscles are stretched and the trunk muscles strengthened. In some cases, bracing may be necessary to allow for proper healing. Progression back to sports is similar to that for sprains and strains. A few special considerations are important in an athlete who has developed a spondylolisthesis.

Athletes with 50% or less forward slippage can usually return to all sporting activities after pain resolves and appropriate rehabilitation has been completed. Athletes with 50% or greater forward slippage are encouraged to participate in less aggravating sports. Also, athletes with a spondylolithesis should be monitored every six months for progressive slippage as they go through any adolescent growth spurt. More information on Spondylolisthesis . What is a Stinger? A stinger is a sports related injury to the nerves about the neck or shoulder. It is sometimes called a burner or nerve pinch injury, but the term stinger is most descriptive of the symptoms that the athlete experiences including painful electrical sensations radiating through one of the arms. While the stinger is usually a spine injury, it is never a spinal cord injury. The stinger occurs most commonly in contact and collision sports, but is not as catastrophic as a spinal cord injury and does not result in paralysis in the arms and legs. A stinger is often not reported by the athlete to the coaches or the athletic trainers since the symptoms can spontaneously resolve within a short period of time.

However, stingers tend to recur and if not properly diagnosed and treated can lead to persistent pain or even arm weakness, which can eventually result in extended lost playing time. Athletes competing in various sports (most common in football and wrestling), playing specific positions (such as defensive back, linebacker or offensive line) or performing certain athletic maneuvers (such as tackling, blocking or executing a take down maneuver) are at greatest risk of sustaining a stinger. The injury occurs in one of two ways: either one of the nerves off the spinal cord in the neck is compressed as the head is forced backward and toward that side; or the nerves in the neck and shoulder are over-stretched as the head is forced sideways away from the shoulder. The athlete will experience sudden and severe painful, stinging sensations in one of his arms frequently lasting from seconds to minutes, occasionally hours and less frequently days or longer. There is often associated weakness of the muscles in the shoulder and arm that are supplied by the injured nerve. The arm symptoms are usually more severe than neck pain. First time stingers will usually recover quickly even without treatment, but there is a greater risk of recurrent injury if left untreated. Each additional stinger will likely result in continued neurologic impairment including muscle weakness.

Stingers do not affect both arms at the same time, although each arm can be affected with different injuries. If both arms are symptomatic at the same time after a neck injury, a spinal cord injury is likely to have occurred which leads to a much different treatment plan. How is it diagnosed? The diagnosis of the stinger requires the expertise of a medical professional. Ideally, the first evaluation of the athlete occurs at the time of injury at the game or match. Because these injuries are not catastrophic, the athlete often exits the "field of play" without assistance. A sideline evaluation will be conducted by the athletic trainer, physical therapist and/or team physician that will include: a determination of the mechanism of the injury, the symptoms experienced by the athlete, and the physical examination findings including assessment of muscle strength. A decision will be made whether or not the athlete is medically cleared to return to that contest. Persistence of symptoms, stiffness or loss of full range of neck motion, muscle spasm and weakness would usually keep the athlete out of competition. Careful medical follow-up evaluations are important and necessary. These examinations should take place regularly until the athlete's condition has normalized.

If the symptoms and/or neurologic findings worsen during the first few days after the injury or continue beyond two weeks, then further medical assessment is necessary. The physician may order specific tests such as X-ray examinations, magnetic resonance imaging (MRI), and an electromyogram (or EMG) which is designed to evaluate for nerve damage. Occasionally a stinger can result from a disk herniation in the neck. If so, this should be confirmed on the MRI. No matter how trivial the injury may appear, in order for the physician to make the correct diagnosis and prescribe the appropriate treatment it is very important for the athlete not to withhold information. If the injury was not witnessed by the medical personnel covering the event, then it is the responsibility of the athlete to report the injury even if the symptoms disappear quickly. In some situations, the effects of the stinger can lead to permanent nerve damage if left undiagnosed and untreated. What treatments are available? The goals of treatment are to reduce the pain and abnormal sensations in the arm, regain the strength of weakened shoulder and arm muscles, and prevent further injuries. There are several nonoperative options for the treatment of an acute stinger.

The order in which these treatments are utilized depends largely on whether the primary complaint is pain or weakness. Treatment for acute pain usually includes activity restriction, ice or heat, anti-inflammatory and pain medications, a cervical collar and cervical traction. Following an acute injury, the athlete is not allowed to return to competition to allow time for recovery. Modalities such as ice and heat can be used both for comfort and to reduce inflammation. Ice is usually applied about the neck and shoulder region up to 48 hours post injury after which time heat is substituted. Nonsteroidal anti-inflammatory medications are frequently prescribed for both reduction of swelling and inflammation as well as pain relief. Stronger analgesics (pain medications) are not usually necessary, but muscle relaxants may be utilized for a short period of time to treat muscle spasm. A cervical collar may also be used for a short period of time to prevent further nerve root injury or irritation. Cervical traction helps to reduce pressure on the nerve root. It can be applied manually or mechanically under the guidance of a physical therapist. Often, trunk strengthening and chest-out posture correction exercises are started.

For persistent pain, cortisone injection around the injured nerve root ("nerve root block") performed with X-ray guidance can be helpful to reduce inflammation of the nerve. If weakness is the main problem, then the acute treatment includes modified activities, ice or heat and anti-inflammatory medication. The majority of stingers are treated successfully without surgery. Surgery is only considered if the injured nerve root is found to be severely compressed by either a disc herniation or bone spur and there is severe persisting pain or worsening weakness. The two surgical options are removal of the disc (discectomy) or bone spur, or discectomy followed by a fusion. In each case, the surgical decision is individualized to the athlete's symptoms and signs and the results of additional diagnostic tests. Prevention Many athletes who sustain a stinger are found to have substantial postural deviations which may interfere with full recovery. Some of these abnormal postures include the head jutting out too far forward from the neck and the shoulders too rounded. These postures will cause more pressure to be placed on some of the nerve roots in the neck making them more likely to be injured and to recover slower after injury.

A comprehensive physical therapy treatment program will be of value to correct the various areas of muscular and soft tissue tightness and weakness throughout the neck, upper back and shoulder region. Trunk stabilization and chest-out posture correction exercises are usually the basis of the treatment program. Physical therapy may also include manual therapy treatments in which the therapist provides deep tissue massage to release tight soft tissues and joint mobilization to loosen stiff spinal joints. Forceful spinal manipulation should be avoided so as not to further injure the cervical nerve root. Therapy includes specific exercises to strengthen the weak muscles of the neck, upper back and arms. Athletes who undergo surgery must also complete a full rehabilitation program. Return to Play Before the athlete can return to regular athletic competition, several goals must be met. First, the athlete must be completely free of pain and weakness and must regain full range of motion of the neck. Second, the diagnostic tests such as the EMG and/or MRI should not reveal any active nerve damage or severe nerve compression. Third, the athlete must be reconditioned for the sport especially if he has not competed for awhile. Fourth, improvement in the athlete's playing technique (such as blocking and tackling) and equipment modifications should be made to protect the athlete from further injury.

In football, special pads and neck rolls can be fitted to the helmet or shoulder pads, which can help prevent re-injury. However, this type of equipment change does not replace the most important part of prevention, which is building strength and endurance of the neck and shoulder muscles. That is why athletes who have had surgery will usually take longer to return to play. Finally, in some cases, the decision to return to play must be delayed especially if the athlete has suffered several stingers in the same season. Healing is usually slower after multiple injuries. The key concern is to avoid permanent nerve damage, which could cause problems in the young athlete's personal as well as athletic life. Rarely does a history of multiple stingers signal the end of an athletic career. The sports medicine physician, working together with the athletic trainers, should provide counseling regarding how serious the injury is and discuss early or delayed return to play. Disc Injury Though it is a common cause of back pain in the adult population, disc injury is relatively uncommon in the young athletic population. Back pain from a disc injury may or may not be associated with sciatica (pain that shoots down the leg).

A careful history and examination is very important in determining if a disc problem may be the cause of the athlete's complaints. Magnetic resonance imaging (MRI) can also be helpful in determining if a disc is a cause for the pain and to rule out other potential causes that may mimic disc injury in an adolescent. Treatment is similar to treatment of a disc herniation in the adult population. (See the NASS Patient Education Brochure on Herniated Disc for more information about this condition.) Injections (epidurals) can be used but are not necessary in most cases. If symptoms do not improve with a comprehensive rehabilitation program, then surgery may be indicated. This is necessary only in a small percentage of young athletes with disc injury. Scheuermann's Disease (juvenile kyphosis) Another common problem seen in the young athlete with back pain is juvenile kyphosis, known as Scheuermann's Disease. Pain associated with this occurs during puberty and is in the mid back, rather than the low back. The athlete demonstrates a roundback deformity that worsens to a "dome" appearance of the back with bending forward.

Diagnosis is made by X-ray examination that shows at least three consecutive vertebra show a wedging of 5° or more. Treatment in most cases is aimed at relieving symptoms. Extension-based back exercises and postural exercises are essential. These can provide significant symptomatic relief, but it is important to note that the structural curve cannot be corrected with these exercises. For curves of 50° or greater, bracing can be helpful if the athlete is able to tolerate wearing the brace. For athletes with severe curves who continue to have debilitating pain despite bracing, surgical correction and stabilization may be required. It is important to note that this may limit the athlete's ability to return to their given sport. As with all spine-based injuries, a complete rehabilitation program is essential prior to return to athletic competition. achondroplasia - Genetics Home Reference achondroplasia Description Achondroplasia is a form of short-limbed dwarfism. The word achondroplasia literally means "without cartilage formation." Cartilage is a tough but flexible tissue that makes up much of the skeleton during early development.

However, in achondroplasia the problem is not in forming cartilage but in converting it to bone (a process called ossification), particularly in the long bones of the arms and legs. Achondroplasia is similar to another skeletal disorder called hypochondroplasia , but the features of achondroplasia tend to be more severe. All people with achondroplasia have short stature. The average height of an adult male with achondroplasia is 131 centimeters (4 feet, 4 inches), and the average height for adult females is 124 centimeters (4 feet, 1 inch). Characteristic features of achondroplasia include an average-size trunk, short arms and legs with particularly short upper arms and thighs, limited range of motion at the elbows, and an enlarged head ( macrocephaly ) with a prominent forehead . Fingers are typically short and the ring finger and middle finger may diverge, giving the hand a three-pronged ( trident ) appearance. People with achondroplasia are generally of normal intelligence.

Health problems commonly associated with achondroplasia include episodes in which breathing slows or stops for short periods (apnea), obesity, and recurrent ear infections. In childhood, individuals with the condition usually develop a pronounced and permanent sway of the lower back ( lordosis ) and bowed legs. Some affected people also develop abnormal front-to-back curvature of the spine ( kyphosis ) and back pain. A potentially serious complication of achondroplasia is spinal stenosis , which is a narrowing of the spinal canal that can pinch (compress) the upper part of the spinal cord. Spinal stenosis is associated with pain, tingling, and weakness in the legs that can cause difficulty with walking. Another uncommon but serious complication of achondroplasia is hydrocephalus, which is a buildup of fluid in the brain in affected children that can lead to increased head size and related brain abnormalities. Related Information Inheritance Pattern Achondroplasia is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. About 80 percent of people with achondroplasia have average-size parents; these cases result from new mutations in the FGFR3 gene.

In the remaining cases, people with achondroplasia have inherited an altered FGFR3 gene from one or two affected parents . Individuals who inherit two altered copies of this gene typically have a severe form of achondroplasia that causes extreme shortening of the bones and an underdeveloped rib cage. These individuals are usually stillborn or die shortly after birth from respiratory failure. Related Information Treatment & Coping | Scoliosis Research Society Scoliosis Research Society Treatment & Coping Is treatment recommended in most scoliosis cases? In 90 percent of cases, scoliotic curves are mild and do not require active treatment. In the growing adolescent, it is very important that curves be monitored for change by periodic examination and standing x-rays as needed. Increases in spinal deformity require evaluation by an orthopaedic surgeon to determine if active treatment is required. What factors determine treatment for scoliosis? Patient age Bone age (the maturation of bone is not always the same as the chronological age) Degree of curvature Location of curve in the spine Status of menses/puberty Associated symptoms such as back pain or shortness of breath What are treatment options for spinal deformities?

The treatment options for scoliosis fall into three main categories: Observation of scoliosis Observation is for curves that have a small degree measurement when patients are growing (adolescent scoliosis), or for moderate size curves (< 40-45 degrees) when patients are done growing. For adults, observation and physical therapy are for those patients who have mild symptoms and have curves that are not large. Nonoperative treatment Nonoperative treatment, such as bracing, is for curves between 25 and 45 degrees in growing children to prevent further progression of the curve while growth of the spine remains. The goal of bracing is to prevent further progression since the brace cannot correct curves. Surgical treatment Surgical treatment is reserved for curves which are generally greater than 50 degrees for adolescent patients and adults. Surgery can be performed for smaller curves if the appearance of the curvature is bothersome to the patient or if symptoms are associated with the scoliosis in the adult patient. The goals of surgical treatment are to obtain curve correction and to prevent curve progression by fusing the spine at the optimum degree of safe correction of the deformity.

This is generally achieved by placing metal implants onto the spine that are then attached to rods, which correct the spine curvature and hold it in the corrected position until fusion, or knitting of the spine elements together. How is treatment determined for adolescents? In planning a child's treatment, a doctor will take into account how severe the child's curve is and where it occurs in the spine. The child's age is also an important factor — if the child's spine is still growing, it will affect treatment choices. The doctor will determine how likely it is that the curve will get worse, and then suggest treatment options to meet the child's specific needs. Most scoliosis surgeons agree that children who have very severe curves (50 degrees and higher) will need surgery to lessen the curve and prevent it from getting worse. What does successful brace treatment require? Early detection while the patient is still growing Mild to moderate curvature Regular examination by the orthopaedic surgeon A well-fitted brace that is replaced if the child outgrows it A cooperative patient and supportive family Maintenance of normal activities, including exercise, dance training, and athletics, with elective time out of the brace for these activities as supervised by the physician.

If my doctor recommends bracing: What happens if I don’t wear a brace? If your doctor recommends a brace and you choose not to wear it, then you run the risk of your curve getting larger.Depending on how big your curve gets, you may need surgery to correct it. Or you may choose to do nothing about the curve and run the risk of it continuing to increase. This may cause various medical and quality of life issues later in your life. What factors influence the recommendation for surgery? Area of the spine involved Severity of the scoliosis Presence of increased or decreased kyphosis Pain (rare in adolescents, more common in adults) Growth remaining Personal factors What questions should I ask my doctor and/or surgeon regarding costs, risks and complications if surgery is recommended? What are the risks of surgery? What testing is needed before surgery? How much does spinal fusion surgery cost? How many spinal surgeries has my surgeon performed and has he or she had good results? If surgery is for my child, should my child see a neurosurgeon? How long will surgery last? Will I be in a lot of pain? What can help me cope with pain? Should I or someone else donate blood? Will I need a transfusion?

How long will I be in the hospital? [If an adolescent] Can my parents stay with me in the hospital? What kind of physical limitations will I have? Do I need to wear a brace after surgery? Will I need physical therapy? How soon after surgery can I shower or wash my hair? When can I go back to school or work? When can I be active again (i.e., play sports)? Will surgery limit my flexibility (e.g., bending over, ability to walk, range of motion?) Should I have allograft bone used for my fusion or my own bone harvested? If I have a spinal fusion, will I need antibiotics before dental work? Will the metal detectors go off in airport security after I have rods placed in my spine? Will I need more than one surgery? Who can I speak with or what can I read to better prepare for surgery? Does smoking interfere with bone healing? Yes. Smoking has been found to delay healing of tissues, including bones. If bone healing does not occur, a scoliosis operation may not end up being successful over the long term. Ask your doctor about methods to try to quit smoking well in advance of any scheduled operations. Can a metal implant (spinal instrumentation) rust or be rejected?

No, the metal implant does not rust, and is not subject to rejection by the body. What happens if no treatment is done? Will the curve get worse? Two factors can strongly predict whether a scoliosis curve will get worse: young age and a larger curve at the time of diagnosis. Children younger than 10 years with curves greater than about 35 degrees tend to get worse without treatment. Once someone is done growing, it is very rare for a curve to progress rapidly. We know from studies that once someone is fully grown, scoliosis less than 30 degrees tends not to get worse, while those curves greater than 50 degrees can get worse over time, by about 1 to 1 1/2 degrees per year. What are other effective ways to cope with scoliosis? Many patients and their parents ask about the effectiveness of treatment options other than bracing and surgery. Kyphosis - NHS Choices Kyphosis Kyphosis Treatment Introduction Kyphosis is curvature of the spine that causes the top of the back to appear more rounded than normal. Everyone has some degree of curvature in their spine. However, a curve of more than 45 degrees is considered excessive.

Sometimes kyphosis doesn't cause any symptoms other than the back appearing abnormally curved or hunched. However, in some cases the condition causes: tenderness of the spine tiredness Back pain can be particularly problematic in adults with kyphosis because the body has to compensate for the spinal abnormality. If you have severe kyphosis, your symptoms may get worse over time. You may also have difficulty breathing and eating. What causes kyphosis? In kyphosis, the normal curve in the middle section of vertebral column (the thoracic vertebrae) is more curved than normal.

There are a number of reasons why this might happen, including: poor posture (postural kyphosis) – slouching, leaning back in chairs and carrying heavy bags can stretch supporting muscles and ligaments, which can increase spinal curvature abnormally shaped vertebrae (Scheuermann’s kyphosis) – if the vertebrae don't develop properly, they can end up being out of position abnormal development of the spine in the womb (congenital kyphosis) – if something disrupts the spine's normal development, two or more vertebrae sometimes fuse together age – as people get older, their spinal curvature can be expected to increase Kyphosis can also develop as a result of a spinal injury. Read more about the causes of kyphosis . Treating kyphosis If you have kyphosis, your treatment depends on how curved your spine is, whether you have any additional symptoms such as back pain, and the underlying causes. Children with kyphosis may be able to be treated using non-surgical methods, such as bracing, to limit the progression of kyphosis as they grow. Treatment for mild kyphosis may not be necessary. Kyphosis rarely requires surgical treatment.

It's only needed in some severe cases to correct the curvature of the spine. Read more about treating kyphosis . Emotional issues Older children with kyphosis may become concerned or embarrassed about the effect the condition has on their appearance, or having to wear a back brace. These concerns can affect different children in different ways. Some children can become socially withdrawn and they may be reluctant to take part in activities, such as PE, where their condition may be exposed. There are no easy answers to these problems, but it can sometimes help to reassure your child that their feelings will improve with time. Complications Complications of kyphosis usually only occur in more severe cases. They include: persistent pain that can't be controlled with medication breathing difficulties caused by the spine compressing the lungs and airways Occasionally, people with kyphosis can have difficulties when the nerves running through the spine become compressed or pinched. This can disrupt nerve signals and cause symptoms such as: numbness or weakness in the arms and legs problems with sense of balance loss of normal bladder or bowel control These serious complications require urgent medical attention and surgery would usually be recommended. Can kyphosis be prevented?

Postural kyphosis can be prevented by being aware of your posture and by taking care of your back. You should encourage your child to: avoid slouching sit correctly – sit upright, ensuring that the small of the back is supported avoid carrying heavy schoolbags that can pull on the back muscles and ligaments; the best schoolbags are well-designed backpacks take regular exercise (see below) to help strengthen the back and keep it flexible; activities such as swimming , running , walking , yoga and pilates are ideal for helping to prevent back problems Further information: Problems of kyphosis | Bodybuilding, Supplements, Diets, Workouts & Fitness Health Magazine Health & Fitness | Given the fact that there are millions of conditions prevalent in today’s world, understanding a few of them along with their symptoms and primary causes will help us understand the way our body works to a much more significant level. Moreover, if we also get a basic understanding about some of the more common medical ailments, their symptoms and causes, we would also be able to work towards early treatment of the condition. This would help in curbing the infection from growing and leading to a fatal condition.

Despite the fact that the condition is rather common, a lot of people are still likely to ask the question ‘what is Kyphosis?’ when the topic is broached. Kyphosis is a bone disorder that is an abnormal curving of the spine structure – commonly referred to as a hump back. Individuals that have a prominent hunch back are patient suffering from this condition and affected by curvature to the upper back. There are five different types of Kyphosis of the spine – Postural Kyphosis, Shceurmannns Kyphosis, Congenital Kyphosis, Nutritional Kyphosis and Gibbus deformity. Postural Kyphsosis is by far the most common of the varieties of the condition and is primarily the development of bad postural habits. Most patients suffering from this version of the condition will be seen to adopt a slouching posture when seated in a chair and the condition can develop in both the young as well as the elderly. Kyphosis in children and the younger generation could be treated by practicing methods of correcting muscular imbalances and other such exercises.

However one of the main causes of Kyphosis in the elderly folk would be hyperkyphosis – which may be caused by a few vertebral fractures. Another factor that plays a huge role in the development of the condition among older people is the fact that there is a significant loss of musculoskeletal integrity that occurs in the body at the person ages. This could be the primary cause of the development of Kyphsosis in the older generation. Sheuermann’s Kyphosis is a condition that could potentially prove to be significantly worse on a cosmetic level as well as cause a significant amount of pain to the suffering individual. Probably one of the biggest complications that arise out of this version of the condition is the fact that the patient will be unable to consciously adjust his or her posture. This is because the apex of the curve, which is located in the thoracic vertebrae, is likely to be quite rigid. The patient is also likely to experience a substantial amount of pain around the apex during periods of intense physical activity, especially when standing or sitting for long periods. Because of the fact that the condition also causes a significant amount of pain, individuals suffering from this version of the condition are likely to see it have a significant impact on the quality of their lives.

Moreover, because of the development of a noticeable hunchback, the aesthetic effect that the condition has may also see the patient shy away from friend’s circles and even, to some extent, any kind of social presence. This version of the condition is known to have genetic traits and may be passed down from one generation to another within the same bloodline. Congenital kyphosis is a condition where the structure of the spine has been affected right from within the womb. Some of the most common cases would show the vertebrae malformed or even fused together, causing significant progressive kyphosis as the child continues to grow. In a majority of these cases, surgical intervention may turn out to be an absolute necessity and need to be undertaken at a very early age. However, one of the biggest problems that one is likely to experience is the fact that the decision to carry out a procedure like this can be very hard to make – given that there are some very grave potential risks to the safety of the child. Despite the fact that the condition will usually develop within the womb, there is also the possibility that the condition could suddenly appear around the teenage years of an individual – more commonly in individuals that suffer from neurological as well as problems like cerebral palsy.

Nutritional kyphsosis is a version of the condition that is likely to stem from a lack of proper nutrition. Much less common than the other varieties, the condition is primarily influenced by the lack of vitamin D – which results in the softening of the bones, thereby resulting in the increased curvature of the spine and limbs under the weight of the child’s body. Gibbus deformity is a type of structural Kyphosis that is usually the result of suffering from tuberculosis at a rather young age. Kyphosis treatment can be attempted through a number of methods. One of the main kyphosis treatments in adults is focused mainly in having some exercises done on a daily basis. However the exercises for kphosis should not include weight bearing exercises. Besides this, it is also necessary that all kinds of strenuous activities also be reduced. It is important to make sure that you attempt any treatment plan when the condition is still only developing as it will allow the spinal structure to readjust itself with relatively greater ease. The spine may tend to straighten slightly with some amount of treatment and mild kyphosis may not cause symptoms to appear that will not be detectable by some kind of routine physical examination.

Approaching any doctor may see you handed a prescription for some pain killers in the event that the condition is causing any amount of discomfort. Performing a number of specialized exercises to help better the posture would also be highly recommended. Surgical treatment may be recommended in the event that the curvature of the problem exceeds 75 degrees and the primary focus of any surgical treatment is restricted to fusing the abnormal spinal segments together as well as maintaining some improvement over the course of a certain amount of time in addition to alleviating any discomfort that may be present in the back of the individual. Popular Posts 5 Common Posture Problems (& How to Fix Them) - BuiltLean Medically Reviewed Last week I attended a full day workshop on “Posture and Movement Analysis” in NYC. 1 About 25 fitness professionals showed up, all of whom exercise regularly. After we conducted a posture assessment for each other, we were shocked to learn that EVERYONE had moderate to severe posture problems. It is very possible that you too have a moderate to severe postural problem that can affect your health and performance. I must admit I have a small to moderate degree of every postural deviation listed in this article!

While this article does not cover how to conduct a comprehensive posture assessment, I chose the 5 most common posture problems I see that are caused by a sedentary lifestyle. For each posture problem, I list the (1) identification, (2) cause, (3) problem, and (4) solution. Keep in mind the solutions listed are only “possible” solutions because some of the causes and problems may not be correctable (i.e. congenital issues, or trauma). Finally, be aware that any posture problem can lead to other problems as the human body is one “kinetic chain”. Posture Problem #1: Over-Pronated Feet Identification – As shown in the photo above, put both hands 1 inch away from each side of your foot. Straighten your ankle so that the space between each hand and your ankle is equidistant. Now naturally let your ankle and feet rest. If your foot and ankle caved inward, you have over-pronated feet. Causes – Obesity, pregnancy, improper footwear, or repetitive pounding on a hard surface can weaken the arch leading to over-pronation and oftentimes flat feet.

Problem – Over-pronation adds stress to the foot, tightens calf muscles, and can internally rotate the knees. Over-pronation often leads to Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-tib Tendonitis and/or Bunions. As many as 20-30% of Americans have flat feet, or over-pronated feet. Solution – If the arch has already fallen, orthotics are the best bet. If the arch is in the process of falling, or is weak, barefoot running/walking may help strengthen the arches, but be sure to check with your doctor (orthotics may be the best bet in this case as well). For more on barefoot running, check out Barefoot Running Research: Benefits of Barefoot Running . Posture Problem #2: Forward Hip Tilt Identification – Identifying a forward tilt can be tricky, but one method is to purposely tilt your pelvis forward as far as you can, then backward as far as you can. You may realize your natural hip tilt is not far away from the exaggerated forward tilt.

Cause – Sitting too much and not stretching, which shortens the hip flexors Problem – Forward hip tilt (aka anterior pelvic tilt) is associated with tight hip flexors, which are a group of muscles on the front of your hips that pull the knee upward. As you walk, tight hip flexors prevent the glutes (butt muscles) from firing/activating, which forces the hamstring muscles to become overworked and excessively tight. If you have tight hamstrings, the root cause may be tight hip flexors and an anterior pelvic tilt. Solution – Stretch your hip flexors with static lunges, such as the Crescent Lunge (See: Yoga For Back Pain ), activate your glutes with exercises like glute bridges, and foam roll and stretch your hamstrings. Posture Problem #3: Hunchback Identification – Have someone take a photo of you standing sideways. If you notice that your upper back is excessively curved (greater than 40-45 degrees) as in the photo to the right, you have hunchback posture.

Cause – Sitting with bad posture, especially at an office doing computer work Problem – Sitting hunched over a computer screen forces chest muscles to tighten, which can cause excessive curvature (kyphosis) of the upper back (thoracic spine). Postural muscles in the upper back weaken and loosen. Solution – Relieve chest tightness with self myofascial release (use a massage ball) and stretching, while strengthening the upper back postural muscles. My favorite exercise for hunchback posture is upper back foam rolling. For more information, check out Correcting Rounded Shoulders From Office Work . Posture Problem #4: Rounded Shoulders Identification – The “Pencil Test” involves holding a pencil (or pen) in each hand. As shown in the photo above, if the pencils are pointing straight forward with your arms comfortably at your sides, that indicates correct posture. If on the other hand the pencils are facing each other, or are rotated at an angle, then you have internally rotated shoulders. Cause – Sitting with bad posture, especially in an office while typing, or using an imbalanced exercise routine with excessive chest pressing. Problem – Sitting hunched over a computer screen forces chest muscles to tighten, which can internally rotate the shoulders forward.

Postural muscles in the upper back weaken and loosen. Solution – The solution is very similar to correcting hunchback posture – relieve chest tightness with self myofascial release (use a massage ball) and stretching, while strengthening the upper back postural muscles. For more information, check out Correcting Rounded Shoulders From Office Work . Posture Problem #5: Forward Head Identification – Have someone take a photo of you standing sideways. As shown in the photo to your right, find the AC joint (bony protrusion on the side of your shoulder) and check if your ear lobe is on top of the AC joint. If your ear lobe extends in front of your AC joint, you have a forward head posture. Cause – Sitting in an office chair hunched over while staring at a computer Problem – Muscles in the back of the neck become tight, along with the upper trapezius and levator scapulae (upper back muscles). Solution – First, practice proper head posture by sliding your head backward while keeping your line of sight ahead. Be sure not to tilt your head upwards as you slide your head back.

Second, get a massage, or use a massage ball against your upper back, which can be very helpful to help relieve tension around your neck. While these 5 common posture problems are just scratching the surface of posture as a very important fitness topic, I hope it helps you think more consciously of your posture and is useful for you. If you are serious about improving your posture, I highly recommend the Trigger Point Therapy Total Body Kit . Osteoporosis | University of Maryland Medical Center Kyphosis, curvature of the spine that causes a humplike deformity What Causes It? Your bone strength and density is partly due to how much calcium and other minerals they contain. Your body is constantly making new bone and breaking down (reabsorbing) old bone. When you are young, this process happens quickly. You make more bone than you lose, so you build bone mass. After your mid 30s, your body continues to make new bone, but more slowly, causing you to lose more bone than you make. The amount of bone you have in your 30s helps determine your risk of developing osteoporosis later. For women, bone loss increases significantly at menopause, when estrogen levels drop.

Although there are multiple causes of bone loss, genetic factors are responsible for 60 to 80% of peak bone mass. Other than age and menopause, causes of osteoporosis can include: Long-term use of certain medications, particularly corticosteroids and thyroid medications (see "Warnings and Precautions" section) Cushing syndrome (when the adrenal glands produce too much of a hormone called cortisol) Kidney failure Diseases of the thyroid or adrenal glands Not getting enough calcium, vitamin D, vitamin A, vitamin K, and magnesium (however, high intake of vitamin A may actually increase the risk of osteoporosis) Anorexia nervosa Diet low in calcium and vitamin D or high in sodium Long-term use of certain medications, including corticosteroids, diuretics, aromatase inhibitors, and thyroid medications Exercise-induced amenorrhea (loss of menses) Having an eating disorder, particularly during the first 2 decades of life Preventive Care Osteoporosis can be prevented. Because your body builds bone mass until you are in your 30s, prevention should start early. Making sure you get enough calcium and vitamin D (required for your body to use calcium) is essential.

Weight bearing exercise, such as walking or lifting weights, as well as other exercises, including tai chi, can also help stave off the disease. Research shows that exercise early in life boosts bone mass, while exercise later in life helps maintain it. Exercise also increases strength, coordination, and balance. Experts recommend 1/2 hour of weight-bearing exercise daily. These are important tools to help prevent falls that cause fractures, especially in the elderly. Other techniques for prevention include: Quitting smoking. Limiting caffeine to about 3 cups of coffee a day. For women, hormone replacement therapy (note that hormone replacement therapy has significant side effects, including increased risk of breast cancer, blood clots, and heart disease). What to Expect at Your Doctor's Office If your doctor believes you are at risk for osteoporosis, they will order a bone mineral density test (BMD) to determine your bone mass. Several tests can measure bone density, and they are all painless, noninvasive, and safe. Some tests measure bone density in the spine, wrist, and hip (the most common sites of fractures due to osteoporosis), while others measure bone in the heel or hand.

The National Osteoporosis Foundation recommends a BMD for women who are not taking estrogen and: Use any medications that increase the risk of osteoporosis Had an early menopause Have a family history of osteoporosis, kidney disease, liver disease, or type 1 diabetes Are over 50, postmenopausal, and have at least one risk factor for osteoporosis Are over 65 and have never had a BMD BMD tests should be repeated every 2 to 5 years depending on the risk factors Treatment Options For those who are at risk for osteoporosis or already have the disease, treatment may help boost bone mass and prevent (further) bone loss. While calcium by itself does not cure or prevent osteoporosis, getting enough calcium is an essential part of any prevention or treatment program. Making lifestyle choices, such as eating a diet rich in fruits and vegetables and doing weight-bearing exercises can also enhance bone strength. Lifestyle Diet Studies suggest that diets rich in the following foods and nutrients may help prevent bone loss in both men and women: Calcium. Low-fat milk, cheese, and broccoli are rich in calcium. Orange juice and cereals often are fortified with calcium Magnesium.

Avocado, banana, cantaloupe, honeydew, lima beans, low-fat milk, nectarine, orange juice, potato, spinach Potassium. Whole grains, nuts, spinach, oatmeal, potato, peanut butter Vitamin D. The body makes vitamin D after exposure to sunlight. It is also found in fatty fish, fortified cereals, and milk. Vitamin K. Leafy greens, cauliflower Fruits Vegetables Exercise Exercise can help prevent bone loss. Although it is best to begin exercising when you are young (to help build bone), it is never too late to get the benefit. Weight-bearing exercise (walking, weight lifting) stimulates bones to produce more cells, slowing bone loss. Exercise also improves balance, flexibility, strength, and coordination, thereby reducing falls and broken bones associated with osteoporosis. Drug Therapies The standard treatment for osteoporosis for postmenopausal women used to be estrogen, but there are new options for men and for women who are wary of estrogen's risks. Most medications slow down the rate at which bone is reabsorbed (antiresorptive). One drug can help the body make new bone (bone forming).

Estrogen (with or without progesterone) boosts bone density and reduces the risk of fracture by slowing bone loss, boosting the body's ability to absorb calcium, and reducing the amount of calcium excreted in the urine. Estrogen by itself can increase a woman's risk for developing cancer in her uterine lining (endometrial cancer), so many doctors have prescribed a combination of estrogen and progesterone. However, evidence now shows that this combination increases a woman's risk of breast cancer, ovarian cancer, blood clots, strokes, and heart attacks. Talk with your doctor to understand the risks and benefits of taking estrogen. There are other options for treating osteoporosis. Alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel), and zoledronic acid (Reclast). These medications belong to a class of drugs known as bisphosphonates. These drugs have been shown to boost bone density, slow or stop bone loss, and reduce the risk of fractures. Side effects are uncommon but may include abdominal pain and heartburn, which can be reduced by taking the medications with 8 oz.

of water first thing in the morning before eating anything else, and standing upright for at least 30 minutes after taking them. Reclast is given intravenously (IV). Raloxifene (Evista), from a class of drugs called Selective Estrogen Receptor Modifiers (SERMS), raloxifene has estrogen-like effects on bone (it prevents bone loss), but does not increase the risk for breast cancer. Side effects can include hot flashes and blood clots. Premenopausal women should not take raloxifene. Calcitonin (Miacalcin) does not improve bone density as well as the bisphosphonates, but it does slow bone loss, reduce spinal fractures, and ease pain associated with bone fractures. An alternative for women who cannot take estrogen or bisphosphonates. Parathyroid hormone (Forteo) used in low doses, this drug can increase bone production. It can only be taken by injection. It is often prescribed for postmenopausal women and men at risk of fracture. Children should not take parathyroid hormone.

Surgery and Other Procedures A procedure called kyphoplasty can treat kyphosis, the humplike deformity sometimes caused by osteoporosis. A catheter inserts a balloon into the middle of a collapsed vertebra and then expands so the height of the vertebra is restored. The surgeon then injects bone cement into the vertebra to hold its shape. Vertebroplasty is another procedure in which cement is injected into the vertebra to reinforce it. Complementary and Alternative Therapies Nutrition and Supplements Eating fruits and vegetables and consuming adequate amounts of calcium and vitamin D are crucial in the prevention and treatment of osteoporosis. Keeping bones healthy throughout life depends on getting enough of specific vitamins and minerals, including phosphorous, magnesium, boron, manganese, copper, zinc, folate, and vitamins B12, B6, C, and K. Avoiding sodium, alcohol, and caffeine will also enhance bone health. Calcium: Calcium helps the body build bone.

Recommended intakes of calcium are as follows (note that you generally get from 500 to 700 mg of calcium in your diet): Children: 800 to 1,200 mg/day Adolescent girls: 1,200 to 1,500 mg/day Premenopausal women (19 to 50 years old): 1,000 mg/day Older adults (51 to 70 years old): 1,200 to 1,500 mg/day The recommended intake for older women is 1,500 mg/day, except for those on estrogen, who need only 1,000 mg/day. Good dietary sources of calcium include: Low-fat dairy products (such as milk, yogurt, and cheese) Dark green, leafy vegetables (such as broccoli, collard greens, and spinach) Salmon Tofu Almonds If you do not get enough calcium from food alone, you may want to take a calcium supplement. There are several varieties available.

Ask your doctor which one is right for you: Calcium citrate (Citrical, Solgar) most easily absorbed and costs more Calcium carbonate (Tums, Caltrate, Rolaids) least expensive and must be taken with meals or a glass of orange (acidic) juice; may cause gas or constipation Calcium phosphate (Posture) easily absorbed, does not cause stomach upset; more expensive than calcium carbonate Calcium supplements should be taken in divided doses during the day, because your body can only absorb 500 mg of calcium at a time. Work with your doctor to make sure you get enough, but not too much, calcium, especially if you are taking any medications. Vitamin D: In order to absorb enough calcium, your body also needs vitamin D. The National Osteoporosis Foundation recommends the following: Adults under age 50: 400 to 800 IU/day Older adults (51 to 70 years old): up to 2,000 IU/day Vitamin K (150 to 500 mcg): Vitamin K, which the body makes in the intestine, helps bind calcium into bone.

A recent study suggests that at menopause, vitamin K may start to lose its ability to bind calcium, so even women with normal levels of vitamin K may not have enough to maintain bone health. Eating 3 servings of low-fat dairy or dark, leafy greens per day can help. Talk to your doctor about whether you need a supplement. However, be especially careful about taking a supplement if you also take blood-thinning medications (diuretics), such as warfarin (Coumadin), aspirin, and others, because vitamin K may interact with these medications. Soy isoflavones: Isoflavones are phytoestrogens, plant chemicals that have some of the same effects as estrogen. Because estrogen helps protect against osteoporosis, researchers theorize that isoflavones may also help stop bone loss. Studies are conflicting, however. The best source of soy isoflavones is through diet (tofu, soy milk, and soybeans). When isoflavones are eaten in foods, they do not appear to have the same negative effects that supplemental estrogen does. If you have a history of hormone-related cancer, talk to your doctor before taking soy.

Soy contains phytic acid, which may block the aborption of calcium and other critical minerals. Ipriflavone (600 mg per day): Ipriflavone, a synthetic isoflavone derived from natural isoflavones found in soy, red clover, and other food sources, may also help prevent and treat osteoporosis. Most studies, though not all, indicate that ipriflavone, when combined with calcium, can slow bone loss and help prevent fractures of the vertebrae (spine) in postmenopausal women. Talk to your doctor before taking ipriflavone. Omega-3 fatty acids, such as those found in fish oil (4 g per day): A few studies have shown that supplements containing essential fatty acids, such as those found in fish oil, can help maintain or possibly increase bone mass. Essential fatty acids appear to increase the amount of calcium your body absorbs, diminish the amount of calcium lost in urine, improve bone strength, and enhance bone growth. Foods rich in essential fatty acids (including cold-water fish, such as salmon) can help raise the amount of essential fatty acids in your diet.

People who are taking blood-thinning medication (anticoagulants) should not take fish oil supplements without talking to their doctor first. Preliminary studies also suggest that the following nutrients may help prevent or treat osteoporosis: Carotenoids. Studies show that carotenoids protect bone mineral density in older men and women Zinc stimulates bone formation and inhibits bone loss in animals. Vitamin C may limit bone loss in early years of menopause. Studies show mixed results. Melatonin is involved in bone growth. Since levels of melatonin drop as you age, it is possible that melatonin may contribute to the development of osteoporosis. More studies are needed. People who take antidepressants or psychiatric medications should not take melatonin without a doctor's supervision. (See the "Warnings and Precautions" section for a list of supplements that people with osteoporosis should avoid.) Herbs Although most herbs have not been studied extensively for the treatment of osteoporosis, some have estrogen-like effects that might offer protection against bone loss. However, they may also carry some of the same risks as supplemental estrogen. They may also interact with blood-thinning medications, such as warfarin (Coumadin) and others.

Talk to your doctor before taking any of these herbs. Black cohosh (Actaea racemosa or Cimicifuga racemosa). Black cohosh contains phytoestrogens (estrogen-like substances that help protect against bone loss). It is often used to relieve menopausal symptoms, although evidence for its effectiveness is mixed. People who have a history of hormone-related cancers, or have a high risk of developing hormone-related cancers (such as breast cancer, among others) should not take Black cohosh except under the supervision of your physician. Red clover (Trifolium pratense). Isoflavones extracted from this herb may slow bone loss in women, but it is not clear whether the whole herb is effective. More tests are needed to prove its effectiveness. Red clover may possibly interact with several medications, and due to its estrogen-like effects. If you have a history of hormone-related cancers, or are at high risk for such cancers, you should not take Red clover except under the supervision of your physician.

Other herbs that may help prevent or treat osteoporosis (evidence is lacking so far) include: Horsetail (Equisetum arvense) contains silicon, believed to strengthen bone Kelp (Fucus vesiculosus L.) used for musculoskeletal disorders; rich in minerals so may be a complementary treatment for osteoporosis Oat straw (Avena sativa) boosts hormone levels that stimulate cell growth Special Considerations Warnings and Precautions Some studies suggest that too much vitamin A may increase the risk for osteoporosis. People with osteoporosis, or those at risk for the disease, should not exceed the daily recommended intake of vitamin A (900 mcg/day for men and 700 mcg/day for women). Certain medications may contribute to the development of osteoporosis when used for long periods of time: Corticosteroids (steroid hormones) Talk to your doctor if you take any of these medications. Prognosis and Complications Bone fractures are the most common complications of osteoporosis and are a significant cause of disability and death. After age 60, 25% of women have a spinal fracture. That percentage doubles after age 75.

By age 90, 33% of women and 17% of men have had a hip fracture, usually from a minor fall or accident. Many elderly people who suffer a hip fracture lose the ability to walk and, most significantly, up to 36% die within one year. Although about 2 million bone fractures in the U.S. each year result from osteoporosis, most are preventable. Several medications are currently being researched that may expand the treatment options available to people with osteoporosis. In the meantime, a combination of medications, diet, exercise, and calcium and vitamin D supplements can help slow the progression of the disease. Supporting Research Alekel DL, St Germain A, Peterson CT, Hanson KB, Stewart JW, Toda T. Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Am J Clin Nutr. 2000;72:844-852. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis. JAMA.

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Zhang J, Delzell E, Curtis JR, et al. Use of pharmacologic agents for the primary prevention of osteoporosis among older women with low bone mass. Osteoporos Int. 2014; 25(1):317-24. Alternative Names

Question: What common name is given to those who suffer from kyphosis?
Answer: Hunchback